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NPI Code Detail

MEDICARE: LUCAS ROUCHER

MEDICARE: LUCAS ROUCHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1982384533
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS ROUCHER
Provider Business Mailing Address
First Line : 2715 LAKESIDE VILLAGE DR
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-4348
Country : US
Telephone Number : 832-387-0519
Fax Number :
Provider Business Practice Location Address
First Line : 1950 ELDRIDGE PKWY
Second Line :
City : HOUSTON
State : TX
Zip : 77077-3448
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2023
Last Update Date : 07/19/2023

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Directions to “ LUCAS ROUCHER ” Practice Location

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